Individual provider Active NPI

Xenia I. Kugler, RN

  • Adult Health Nurse Practitioner
  • Bellefonte, PA
National Provider Identifier
1740843531
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP020767 Issued in PA
Practice address
141 Medical Park LN
Bellefonte, PA 16823-9112
Phone
(814) 355-7322
Fax
(814) 355-9604
NPI assigned
Apr 17, 2019
Last updated
Sep 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP020767 PA Primary
Gerontology Nurse Practitioner 363LG0600X SP020767 PA

Addresses

Primary practice location

141 Medical Park LN
Bellefonte, PA 16823-9112

Mailing address

141 Medical Park LN
Bellefonte, PA 16823-9112
Phone (814) 355-7322

Other names 1

  • Xenia Iris Kedrick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191003001787 PA Practitioner - Nurse Practitioner 0648501759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centre Geriatric Care, LLCGroup PAC ID 1355731670, 2 clinicians

Practice addresses (Care Compare)

250 Persia Rd
Bellefonte, PA 16823-9525
Phone (814) 272-5805

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
SP020767PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centre Geriatric Care, LLC CurrentSince Nov 17, 2021 Accepting new patients
Nittany Valley Medical Associates P.C. PastSince May 1, 2018 Accepting new patients

Locations

250 Persia Rd
Bellefonte, PA 16823
Phone (814) 278-6000

2134 Sandy Dr
Ste 16
State College, PA 16803

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1740843531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 MEDICAL PARK LN",
            "city": "BELLEFONTE",
            "state": "PA",
            "postal_code": "168239112",
            "telephone_number": "814-355-7322",
            "fax_number": "814-355-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUGLER",
        "first_name": "XENIA",
        "middle_name": "I.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP020767",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP020767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "XENIA",
            "last_name": "KEDRICK",
            "middle_name": "IRIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellefonte, PA

Sources for this page

Verify at the official NPI Registry.